Biden Administration Proposes No-Cost Access to Over-the-Counter Birth Control for Women

The Biden administration is introducing a proposed rule aimed at enhancing access to contraceptives for women with private health insurance. Announced on Monday, this initiative would allow women to obtain over-the-counter birth control pills and other contraceptives at no cost. The rule is a significant expansion of the federal mandate that requires health insurers to provide coverage for preventive care services at no expense to patients, as outlined in the Affordable Care Act.

The proposal comes from the Departments of Health and Human Services, Labor, and the Treasury, and is expected to take effect in 2025 if finalized. According to Jennifer Klein, the Director of the White House Gender Policy Council, this rule could benefit approximately 52 million women of reproductive age who have private health insurance. For the first time, women would be able to access over-the-counter contraception without a prescription at no additional cost, and health plans would be obligated to cover prescribed contraceptives without requiring cost-sharing.

Currently, Perrigo Co’s Opill is the only daily birth control pill approved for over-the-counter sale by the U.S. Food and Drug Administration (FDA). However, the proposed rule would extend coverage to a variety of other over-the-counter contraceptives, including emergency contraception options like Plan B, as well as spermicides, birth control sponges, and condoms.

Additionally, the rule mandates that health plans cover all FDA-approved contraceptive drugs and certain devices, such as intrauterine devices (IUDs), without cost-sharing in many circumstances. Plans would also be required to provide information about the coverage of over-the-counter contraceptives, including details on any applicable cost-sharing or prescription requirements.

This proposal emerges in a politically charged context, just weeks ahead of the 2024 presidential election, where abortion rights have become a pivotal issue following the Supreme Court’s 2022 decision to overturn Roe v. Wade. Vice President Kamala Harris, the Democratic nominee, has emphasized access to abortion as a central theme in her campaign. In contrast, Republican candidate and former President Donald Trump has remarked on the role of state legislation in determining abortion laws, refraining from advocating a national ban that could alienate moderate voters.